133 kids got Zoloft alone -- beginning with 25 milligrams per day and
adjusted up to 200 milligrams per day within eight weeks, including eight 30-
to 60-minute sessions to rate treatment response and adverse events.

24% of the kids in the placebo group were "very much" or
"much" improved.

55% of the kids in the Zoloft group were "very much" or
"much" improved.

60% of the kids in the CBT group were "very much" or "much"
improved.

81% of the kids in the CBT/Zoloft combination group were "very
much" or "much" improved.

Walkup and colleagues conclude that all three of the active treatments --
CBT, Zoloft, or the combination -- are effective short-term treatments for kids
with anxiety disorders.

"Among these effective therapies, combination therapy provides the best
chance for a positive outcome," they conclude.

Zoloft treatment worked the fastest, with rapid initial improvement but
little additional improvement after eight weeks of treatment. CBT took eight to
12 weeks to work.

Most kids with anxiety disorders don't get diagnosed or treated, notes an
editorial by Graham J. Emslie, MD, of the University of Texas Southwestern
Medical Center, Dallas.

That's too bad, he says, because research now shows that untreated childhood
anxiety persists into adulthood.

"This trial answers the most compelling question about the treatment of
anxiety disorders: Treatment is indicated," Emslie states.

Zoloft is an SSRI
antidepressant. Like other members of its class, the drug has been linked
to
suicidal thoughts in children and adults. But in the Walkup study, there
were no more suicidal thoughts in kids taking Zoloft than in kids taking
placebo pills.

However, kids taking Zoloft reported more insomnia,
fatigue, sedation, and restlessness than kids in the CBT group.

Zoloft is made by Pfizer. Pfizer provided the Zoloft and placebo pills used
in the study, but did not provide other support for the study and was not
involved in the design or implementation of the study. Walkup and colleagues
report receiving various fees and research support from various pharmaceutical
companies.

The study findings, and the Emslie editorial, appear in the Dec. 25 issue of
the New England Journal of Medicine.